This article was downloaded by: [Lakehead University] On: 15 March 2015, At: 22:55 Publisher: Taylor & Francis Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK
Human Vaccines & Immunotherapeutics Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/khvi20
Incorporating immunizations into routine obstetric care to facilitate Health Care Practitioners in implementing maternal immunization recommendations abc
Heather Webb
c
abcd
, Jackie Street & Helen Marshall
a
Vaccinology and Immunology Research Trials Unit; Women’s and Children’s Hospital; Adelaide, South Australia, Australia b
School of Paediatrics and Reproductive Health; University of Adelaide; Adelaide, South Australia, Australia c
School of Population Health; University of Adelaide; Adelaide, South Australia, Australia
d
Click for updates
Robinson Institute; University of Adelaide; Adelaide, South Australia, Australia Published online: 07 Feb 2014.
To cite this article: Heather Webb, Jackie Street & Helen Marshall (2014) Incorporating immunizations into routine obstetric care to facilitate Health Care Practitioners in implementing maternal immunization recommendations, Human Vaccines & Immunotherapeutics, 10:4, 1114-1121, DOI: 10.4161/hv.27893 To link to this article: http://dx.doi.org/10.4161/hv.27893
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http:// www.tandfonline.com/page/terms-and-conditions
Research Paper Research Paper
Human Vaccines & Immunotherapeutics 10:4, 1114–1121; April 2014; © 2014 Landes Bioscience
Incorporating immunizations into routine obstetric care to facilitate Health Care Practitioners in implementing maternal immunization recommendations Vaccinology and Immunology Research Trials Unit; Women’s and Children’s Hospital; Adelaide, South Australia, Australia; 2School of Paediatrics and Reproductive Health; University of Adelaide; Adelaide, South Australia, Australia; 3School of Population Health; University of Adelaide; Adelaide, South Australia, Australia; 4Robinson Institute; University of Adelaide; Adelaide, South Australia, Australia
1
Downloaded by [Lakehead University] at 22:55 15 March 2015
Keywords: maternal immunization, influenza, pertussis, obstetricians, vaccines Abbreviations: HCPs, health care professionals; VPDs, vaccine preventable diseases; GPs, general practitioners; MMR, measles, mumps and rubella; SA, South Australia; SAPR, South Australian Pregnancy Record; NWHPR, National Woman Held Pregnancy Record; SIDS, sudden infant death syndrome
Immunization against pertussis, influenza, and rubella reduces morbidity and mortality in pregnant women and their offspring. Health care professionals (HCPs) caring for women perinatally are uniquely placed to reduce maternal vaccine preventable diseases (VPDs). Despite guidelines recommending immunization during the perinatal period, maternal vaccine uptake remains low. This qualitative study explored the role of obstetricians, general practitioners, and midwives in maternal vaccine uptake. Semi-structured interviews (n = 15) were conducted with perinatal HCPs at a tertiary maternity hospital in South Australia. HCPs were asked to reflect on their knowledge, beliefs, and practice relating to immunization advice and vaccine provision. Interviews were transcribed and coded using thematic analysis. Data collection and analysis was an iterative process, with collection ceasing with theoretical saturation. Participants unanimously supported maternal vaccination as an effective way of reducing risk of disease in this vulnerable population, however only rubella immunity detection and immunization is embedded in routine care. Among these professionals, delegation of responsibility for maternal immunization was unclear and knowledge about maternal immunization was variable. Influenza and pertussis vaccine prevention measures were not included in standard pregnancy record documentation, information provision to patients was “ad hoc” and vaccinations not offered on-site. The key finding was that the incorporation of maternal vaccinations into standard care through a structured process is an important facilitator for immunization uptake. Incorporating vaccine preventable disease management measures into routine obstetric care including incorporation into the Pregnancy Record would facilitate HCPs in implementing recommendations. Rubella prevention provides a useful “template” for other vaccines.
Introduction Pertussis, influenza, and rubella are vaccine preventable diseases with potentially severe consequences for newborn infants1-3 and in the case of influenza, for pregnant women.3,4 Maternal vaccination is a recommended part of perinatal care to provide protection for both mother and infant.1-4 However, in Australia, perinatal maternal uptake of pertussis and influenza vaccines is low,5-8 and despite a universal childhood immunization program, pertussis control remains problematic with epidemics occurring every 3–4 y.9 Infants
Human Vaccines & Immunotherapeutics Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/khvi20
Incorporating immunizations into routine obstetric care to facilitate Health Care Practitioners in implementing maternal immunization recommendations abc
Heather Webb
c
abcd
, Jackie Street & Helen Marshall
a
Vaccinology and Immunology Research Trials Unit; Women’s and Children’s Hospital; Adelaide, South Australia, Australia b
School of Paediatrics and Reproductive Health; University of Adelaide; Adelaide, South Australia, Australia c
School of Population Health; University of Adelaide; Adelaide, South Australia, Australia
d
Click for updates
Robinson Institute; University of Adelaide; Adelaide, South Australia, Australia Published online: 07 Feb 2014.
To cite this article: Heather Webb, Jackie Street & Helen Marshall (2014) Incorporating immunizations into routine obstetric care to facilitate Health Care Practitioners in implementing maternal immunization recommendations, Human Vaccines & Immunotherapeutics, 10:4, 1114-1121, DOI: 10.4161/hv.27893 To link to this article: http://dx.doi.org/10.4161/hv.27893
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http:// www.tandfonline.com/page/terms-and-conditions
Research Paper Research Paper
Human Vaccines & Immunotherapeutics 10:4, 1114–1121; April 2014; © 2014 Landes Bioscience
Incorporating immunizations into routine obstetric care to facilitate Health Care Practitioners in implementing maternal immunization recommendations Vaccinology and Immunology Research Trials Unit; Women’s and Children’s Hospital; Adelaide, South Australia, Australia; 2School of Paediatrics and Reproductive Health; University of Adelaide; Adelaide, South Australia, Australia; 3School of Population Health; University of Adelaide; Adelaide, South Australia, Australia; 4Robinson Institute; University of Adelaide; Adelaide, South Australia, Australia
1
Downloaded by [Lakehead University] at 22:55 15 March 2015
Keywords: maternal immunization, influenza, pertussis, obstetricians, vaccines Abbreviations: HCPs, health care professionals; VPDs, vaccine preventable diseases; GPs, general practitioners; MMR, measles, mumps and rubella; SA, South Australia; SAPR, South Australian Pregnancy Record; NWHPR, National Woman Held Pregnancy Record; SIDS, sudden infant death syndrome
Immunization against pertussis, influenza, and rubella reduces morbidity and mortality in pregnant women and their offspring. Health care professionals (HCPs) caring for women perinatally are uniquely placed to reduce maternal vaccine preventable diseases (VPDs). Despite guidelines recommending immunization during the perinatal period, maternal vaccine uptake remains low. This qualitative study explored the role of obstetricians, general practitioners, and midwives in maternal vaccine uptake. Semi-structured interviews (n = 15) were conducted with perinatal HCPs at a tertiary maternity hospital in South Australia. HCPs were asked to reflect on their knowledge, beliefs, and practice relating to immunization advice and vaccine provision. Interviews were transcribed and coded using thematic analysis. Data collection and analysis was an iterative process, with collection ceasing with theoretical saturation. Participants unanimously supported maternal vaccination as an effective way of reducing risk of disease in this vulnerable population, however only rubella immunity detection and immunization is embedded in routine care. Among these professionals, delegation of responsibility for maternal immunization was unclear and knowledge about maternal immunization was variable. Influenza and pertussis vaccine prevention measures were not included in standard pregnancy record documentation, information provision to patients was “ad hoc” and vaccinations not offered on-site. The key finding was that the incorporation of maternal vaccinations into standard care through a structured process is an important facilitator for immunization uptake. Incorporating vaccine preventable disease management measures into routine obstetric care including incorporation into the Pregnancy Record would facilitate HCPs in implementing recommendations. Rubella prevention provides a useful “template” for other vaccines.
Introduction Pertussis, influenza, and rubella are vaccine preventable diseases with potentially severe consequences for newborn infants1-3 and in the case of influenza, for pregnant women.3,4 Maternal vaccination is a recommended part of perinatal care to provide protection for both mother and infant.1-4 However, in Australia, perinatal maternal uptake of pertussis and influenza vaccines is low,5-8 and despite a universal childhood immunization program, pertussis control remains problematic with epidemics occurring every 3–4 y.9 Infants
